426216168-5-17-2022-17-CC-FVEZ-CEHVSM-20220517164144

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426216168
Report Date: 05/17/2022
Date Signed: 05/17/2022 04:41:52 PM

Document Has Been Signed on 05/17/2022 04:41 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	CORREA FCC AKA ALYSSA'S CHILD CARE		FACILITY NUMBER:	426216168
ADMINISTRATOR:	ALYSSA CORREA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 966-1964
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93454
CAPACITY:	14	CENSUS: 11	DATE:	05/17/2022
TYPE OF VISIT:	POC	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Alyssa Correa		TIME COMPLETED:	12:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 05/17/2022 at 10:20 am, Licensing Program Analyst (LPA) Francisca Velazquez conducted an unannounced Proof of Correction (POC) Inspection at the above Family Child Care Home (FCCH). LPA asked pre-screening questions related to COVID - 19 and based on licensee's responses it was determined that the home was safe and free of any COVID -19 exposure on site. Upon arrival, LPA observed a white van in the front of the home and observed that Licensee was standing right outside the van. LPA observed that the driver was Assistant, Jessica Garcia. LPA was not able to see the number of children inside the van. LPA observed that Licensee walked back into the home as soon as Licensee noticed LPA had arrived. Upon entering the home, LPA observed eleven (11) children and Licensee present during the inspection. LPA did not observe any other adults present in the home. On 05/06/2022, Licensee/FCCH was cited of the following Type A deficiencies: 1. 102416.5 - The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time. During today’s inspection, License was out of capacity with eleven (11) children being supervised by one (1) adult, Licensee. 2. 102425(b) - Cribs or play yards shall be free from all loose articles and objects. During today’s inspection, LPA observed that the crib had one (1) baby bottle. LPA also observed that no infant was in the crib during this inspection. CONT 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CORREA FCC AKA ALYSSA'S CHILD CARE	FACILITY NUMBER: 426216168
	VISIT DATE: 05/17/2022

NARRATIVE

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3. 102425(j)(d) - Documentation shall be maintained in the infant’s file...for review. Documentation shall include the following: a. Date b. Infant’s name c.Time of each 15-minute check. During today’s inspection, Licensee did not have 15 minute sleep logs readily available for review. Licensee stated that after reviewing the safe sleep regulations, Licensee understood that if child was rolling or older than one (1) year, Licensee was no longer required to document 15 minute check.
4. 102425(j)(5)(a) - If the infant is sleeping in a separate room from where the provider is stationed, the door to the room the infant is sleeping in shall remain open at all times. (A) The provider shall be able to visually observe the infant without moving the door. During today’s inspection, LPA observe that infant children were being supervised by adults at all times.

On 05/06/2022, Licensee/FCCH was cited of the following Type B deficiencies:
1. 102417(g)(3) - Where children less than five years old are in care, stairs shall be fenced or barricaded. During today’s inspection, LPA observed that gate located in the bottom step of the stairway was secured and locked.
2. 102417(g)(1) - Fireplaces and open-face heaters shall be screened to prevent access by children. During today’s inspection, LPA observed that fireplace located in children’ play room has been made inaccessible by a secured fence that was placed in front of the fireplace.
3. 102417(g)(4) - Poisons, detergents, cleaning compounds, medicines...pose a danger if readily available to children shall be stored where they are inaccessible to children. During today’s inspection, LPA observed that in the children restroom a child safety latch was added to the cabinet located under the sink. Licensee stated that cleaning compounds/toxins are no longer stored in the children bathroom. LPA observed toilet paper was the only item in the cabinet. LPA also observed that a safety door knob was added to the laundry room. In addition, Licensee has added a safety gate to make the washing machine, drying machine and laundry detergents inaccessible to children in care.
CONT 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2022

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CORREA FCC AKA ALYSSA'S CHILD CARE	FACILITY NUMBER: 426216168
	VISIT DATE: 05/17/2022

NARRATIVE

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4. 102421 - The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419. During today’s inspection, out of the eleven (11) children present, four (4) children did not have a file available for review. After reviewing the seven (7) files available, LPA notes that four (4) files did not have immunization record to review.
5. 102417(g)(8) - Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. During today’s inspection, Licensee had a facility roster available for review.

During today's inspection, it was observed that Licensee is not using the garage which was identified as an off-limit area to the children in care. Licensee stated that she has been working on the garage to ensure it’s safety and would like to start using it. LPA advise that licensee submit and update facility sketch so LPA can return to inspect the areas that will be added.

LPAs recommended Licensee to attend the virtual Spanish orientation for refresher purposes which the licensee agreed to. LPA also recommends Licensee attend a Safe Sleep Regulation course offered by resource and referral. LPA also recommends Licensee participated in Technical Support Program for continual guidance on Title 22 regulations.

The following Type A deficiency are now cleared: CCR 102425(j)(5)(a). The following Type B deficiencies are now cleared: CCR 102417(g)(3), CCR102417(g)(1), CCR 102417(g)(4), CCR 102417(g)(8).

Deficiencies were cited during this inspection and are documented in LIC809- Case Management Deficiencies.

The report and appeal rights were reviewed and translated in Spanish by LPA Francisca Velazquez.

Notice of Site Visit was issued. Exit interview was conducted with Licensee, Alyssa Correa.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2022

LIC809 (FAS) - (06/04)

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